Sexual relationships, condom use and risk perception among female bar workers in north-west Tanzania.

This paper discusses the background characteristics, sexual relationships, condom use and risk perception of bar workers in Magu district, north-west Tanzania. Bar workers in Magu are geographically mobile. They are not highly educated but probably have a higher level of schooling than average. They are mostly unmarried or divorced. They choose bar work because, given the resources available, it provides them with a good balance between earning their own income and being independent. Although the women are still partially dependent on the financial support provided by sexual partners and sexual relations tend to be based on exchange, bar workers cannot simply be equated with prostitutes. Some have a regular partner and the odd casual partner while others may have large numbers of casual contacts. Regular partners are almost always married and often itinerant. The distinction between regular and casual partners is important and based on the nature and extent of financial support. It is also related to condom use and therefore to risk. Women claim to be able to demand condom use from casual partners but not from regular partners. Although women claim that regular partners can be trusted, they nonetheless admit feeling at risk of AIDS and STDs from these same partners.

PIP: A multidisciplinary research study conducted in northwest Tanzania's Magu district in 1993 sought to increase understanding of the characteristics of female bar workers, who are regarded by local authorities as a group at high risk of human immunodeficiency virus (HIV). 33 of the approximately 80 bar, brew shop, and guest house workers in Magu Town were interviewed or enrolled in focus group discussions. In 1994, follow-up interviews were conducted with 27 of these women. The average age of study respondents was 25 years. Bar workers in Magu are predominantly divorced or unmarried and have a high degree of geographic mobility. They select bar work as an alternative to financial dependence on their families. However, because bar workers earn an average of only Tsh 3000 a month (national average monthly income, Tsh 10,000), they remain partially dependent on the financial support of sexual partners. These women provide sex to men in exchange for direct or indirect financial support. The difference between regular and casual partners was expressed by respondents primarily in financial terms. Regular partners, who are usually married, support a woman over an extended period and provide assistance in times of acute need (e.g., illness, school fees), while casual partners exchange a predetermined amount of money for a single sexual encounter. This distinction affects perceptions of risk and condom use. Women are more likely to demand condom use with casual partners, despite the perception that their regular partners also expose them to the risk of HIV. Overall, these bar workers accept the dominant ideology that men are naturally promiscuous and non-monogamous.

HIV infection and sexual behaviour among women with infertility in Tanzania: a hospital-based study.

BACKGROUND: Infertility is common in Africa, but virtually no data exist on HIV prevalence among infertile women. Mainly anthropological studies in Africa have shown that infertile women have higher risks of marital instability and possibly also have more sexual partners than fertile women. METHOD: This study was conducted in a hospital in northwest Tanzania during 1994 and 1995. Women presenting themselves with infertility problems to the outpatient clinic were interviewed, examined and blood was drawn. Women who came to deliver in the hospital, excluding primiparae, were taken as a control group. The analysis was limited to women > or = 24 years. In total 154 infertile and 259 fertile women were included in the study. RESULTS: HIV prevalence was markedly higher among infertile women than among fertile women: 18.2% and 6.6% respectively (adjusted odds ratio [OR] for age, residence and occupation 2.7; 95%-confidence interval [CI]: 1.4-5.3). Data on past sexual behaviour showed that infertile women had more marital breakdowns, more lifetime sexual partners and a higher level of exposure to sexually transmitted diseases (STD). CONCLUSION: Women with fertility problems appear to have higher HIV prevalence, which justifies more attention for such women in the context of AIDS programmes. In addition, caution is needed when using sentinel surveillance data from antenatal clinics to monitor HIV prevalence.

PIP: Infertility is common in Africa. Anthropological studies conducted on the continent have found infertile women to have higher risks of marital instability and possibly more sex partners than fertile women. Findings are reported from a study conducted during 1994 and 1995 in a hospital in northwest Tanzania to determine the prevalence of HIV infection among infertile women. Women presenting with infertility problems to the outpatient clinic were interviewed, examined, and blood was drawn. Women who came to deliver in the hospital, excluding primiparae, comprised the control group. A total of 154 infertile and 259 fertile women were included in the study, all age 24 years and older. 18.2% of infertile women and 6.6% of fertile women were infected with HIV. Data on past sex behavior indicated that infertile women had more marital breakdowns, more lifetime sex partners, and a higher level of exposure to sexually transmitted diseases.

Country watch: Tanzania.

PIP: Previous narrative research by TANESA found rural primary school students in Mwanza Region to be sexually active from the age of 12 years. The Regional Education Office established a program to protect primary school girls from sexual abuse following 1995-96 reports to the rural School AIDS Committees (SACs) that female students were being sexually harassed and abused by primary school teachers. The program involves training selected female teachers to be guardians who help students with social, sexual, and reproductive health problems. The women, at least 35 years old, are selected by school board members and other teachers. One-day training workshops began in February 1996 and by October 1996, 185 female guardians had been trained in the 63 schools of Mwanza District and 122 of the 156 schools in Magu District. Workshop objectives and activities are described. Some program successes have already been achieved.^ieng